Complete Story

On June 8, 2016, Governor John Kasich signed HB 523 into law, adding Ohio to the growing list of states seeking to bypass the FDA drug approval process for 'medical marijuana.'

The bill itself is lengthy and wide-ranging, but ultimately leaves many details up to regulatory agencies tasked with overseeing and controlling marijuana's distribution. For an overview of the law, Jackie Borchardt with the Cleveland Plain Dealer has a good primer that can be accessed here. Additionally, Ohio Legislative Services Commission has comprised an excellent summary of the law here.

How did we get here?Last year, Ohio legislators began discussing the concept of medical marijuana legalization and conducted special meetings and hearings around the state. Several OPA members and volunteers provided their individual perspectives to legislators in those forums. After the conclusion of those hearings, legislation began being developed.

HB 523, sponsored by Rep. Stephen Huffman, who is also a physician, was originally introduced with the intent to allow patients who may benefit from medical marijuana usage to ultimately get access to the product via safer, standardized, controlled means. The original version, which did not involve pharmacists in the distribution process, became an interesting, challenging quandary for OPA and our board.

At the time, then OPA President Jeff Bartone instituted a special Medical Marijuana Task Force chaired by OPA Past President Joe Sabino. The task force was comprised of pharmacists from many different practice settings with varying opinions on the legitimacy of medical marijuana and its possible utilization in Ohio.

Unfortunately, Ohio was is in a bit of a political pickle. After a crushing defeat at the polls last year, marijuana legalization advocates worked to make a ballot initiative that was more palatable for a general electorate, and they worked to get another ballot initiative set for November 2016. Several proposals were pursued, and after polls began showing that a ballot initiative was to likely pass, a legislative solution became more and more likely to ensure marijuana laws were developed carefully by legislators versus being dictated by special interests via ballot.

Both the House and the Senate both pursued their own language initially. Rep. Huffman, Rep. Dan Ramos, and Rep. Kirk Schuring led the language development in the House, and Senator Dave Burke and Senator Kenny Yuko began looking at language as well. HB 523 from Rep. Huffman was the initial vehicle, and once the bill passed the House, the Senate worked to improve upon the language.

While OPA had members and volunteers with many different perspectives on what stance to take, the Task Force and the Board ultimately decided that, while our preference was to not allow marijuana to bypass the FDA approval process, the political reality was that in an effort to maintain control over the process (rather than concede the issue to voters), it was clear the legislature was going to pass a bill, so it was our job to work to do what we could to make it as good as possible (or to make it less bad, depending on your perspective).

So, OPA began discussing our members' concerns with legislators in both chambers. One of those primary concerns was the fact that a yet-to-be adequately tested and reviewed drug was slated to be dispensed by a non-medically trained dispensary worker, commonly referred to as a 'bud-tender.' OPA member and Senator Dave Burke also stated his concerns with this model, and he worked to amend the bill to require that only a licensed pharmacist could dispense the product. After much careful, thoughtful deliberation and legislative work, Senator Burke was successful in amending the bill.

Senator Burke engaged OPA on his amendment, and the OPA board of trustees met to discuss the proposal. Ultimately, the board could not agree to support the legislation in its entirety, but in light of Senator Burke's amendment, the board voted to go from opposed to the the bill to neutral.

However, after Senator Burke's successful amending of the bill, which put pharmacists in charge of dispensing medical marijuana, marijuana legalization advocates came out in full force against the change.

OPA Executive Director Ernie Boyd, OPA President Chet Kaczor, and several other pharmacists submitted testimony in committee raising concerns with any proposal to legalize medical marijuana without pharmacist oversight and control. Unfortunately, OPA learned that within just 48 hours after Senator Burke's amendment being accepted, the bill would be revised again to eliminate the requirement that pharmacists had to dispense the product.

The bill was amended in committee again to remove the pharmacist requirement, then passed out of committee, and then quickly passed through both chambers. The bill went to Governor Kasich's desk, where it was signed into law.

What happens now?Even though HB 523 leaves a lot to be desired, beating the the ballot initiative was the main goal of the legislature. Fortunately, it was recently announced that marijuana legalization advocates were going to suspend their ballot initiative campaign. Again, regardless on your thoughts on the issue, the announcement is a mini-victory, as the ballot push was significantly worse. The decision to back off the ballot initiative shows that the bar has been lowered just enough for marijuana advocates to be satisfied ... for now.

The relatively good news in this is there is going to be a good amount of regulatory oversight of the marijuana distribution process. First, the law calls for the creation of a 14-member Medical Marijuana Commission, for which two of those members must be pharmacists. This commission will assist in the crafting of rules.

The law also calls for regulation and oversight by the Ohio Department of Commerce, the Ohio State Medical Board, and the Ohio Board of Pharmacy. Each of those agencies will begin developing rules in the near future, and OPA will be sure to follow and provide pharmacist input on those rules.

That's not all. While HB 523 has become law, there is a strong possibility that that law will be adjusted over the course of the next two years. OPA is currently seeking member input on what should be changed in the law, what clinical problems could arise with usage of medical marijuana, and what is missing when it comes to ensuring medical marijuana distribution that is as safe as it can possibly be. To submit your feedback, please contact Antonio Ciaccia at aciaccia@ohiopharmacists.org.

The bottom lineThe issue of medical marijuana has required OPA's board, volunteers, members, and staff to do quite a bit of dialogue, reflection, analysis, and soul-searching – just as legislators have done. With the threat of a likely-to-pass ballot initiative from marijuana advocates we can appreciate the difficult position and pressure the legislature was under to get legislation completed quickly. Despite the somewhat reasonable political realities, HB 523 leaves a lot to be desired. As we've stated, regardless of whether you think medical marijuana is legitimate or not, we believe that if Ohio is going to allow for its sale, the standards should be higher; not lower. We applaud Senator Burke for his work to get it right, and we appreciate the care he and his staff put in to improve the bill. OPA understands that achieving perfection on such a difficult issue is not likely, but we will work to ultimately ensure that medical marijuana distribution is done properly and safely for Ohio patients.

Outside of the support of volunteers and members, and the work of OPA's legislative staff in building coalitions and meeting with legislators, supporting political campaigns is a huge part of the advocacy process. We need to support good legislators who support pharmacy and the patients we serve, and we need to build on these recent success by working towards even bigger goals. Please consider financial support of our legislative efforts by contributing to the OPA Pharmacy PAC. 100% of Pharmacy PAC money contributed by pharmacists goes to help candidates who support pharmacy in Ohio. Or if you'd like to make a corporate contribution to support OPA's investment in our advocacy program, please consider being a part of the OPA Legislative Defense Fund (LDF).